Gastro-oesophageal reflflux SCENARIO Jim is a three-month-old baby born at 35 weeks’ gestation. He has been in hospital since birth with a variety of problems. He is now feeding enterally via a...

Gastro-oesophageal reflflux SCENARIO Jim is a three-month-old baby born at 35 weeks’ gestation. He has been in hospital since birth with a variety of problems. He is now feeding enterally via a bottle, but is not thriving and his weight is falling off the centile chart. He has been on feed thickeners and ranitidine for the last month for gastro-oesophageal reflflux, but symptoms still persist. QUESTIONS: 1 What is gastro-oesophageal reflux and what are the main symptoms? 2a What is the rationale behind the ranitidine treatment already started? 2b What alternative class of drug may work in the same way as ranitidine, but be more effective? 2c What are the practical problems of using this second class of medicine in an infant? 3a Name three prokinetic agents which could be added to the regimen at this stage. 3b What is the rationale of use of these products? 3c Briefly mention the potential issues surrounding the use of each product.